细绎病源，本属暑湿热三气之因也，始而湿秘，后以热结，所感暑邪能不久变乎？然此
初、中、末三者，而道其常，尚未言其变。所变者何？昔肥今瘦，瘦人多火，湿已化火，火已就
燥，而况更有变者。痰结肺经，而取效葶、杏，热结肠间，又增大便如栗。甚至肺与大肠相为
表里，二金同受火刑，皮肤燥脱，岂非湿生痰，痰生热，热生风之一验乎？若夫水液混浊皆属
于热，内热生痿，不能起床，鼻之燥、耳之鸣，眼之泪，热象不一而足，阴亦不一而伤。至于
口中不渴，似属令人不解，然亦不难。曰久病入络，络亦主血，血主濡，所以但干而不渴耳。
宗无阴则阳无以化例，请政。
鲜首乌 姜炒山栀 石决明 方解青盐 杏仁 牛膝 柏子仁
阴络伤则血溢，血内溢则后血。血之从后出者已经数载，时发时止，惟有盛于去年也。
今春荣血日亏，卫气益虚。虚则气不摄血，亦因咳而来，阳络更伤，中焦失守，不独肝肾内
虚，无怪乎其浮肿于前，喘促于后。甚至饮食不思，恶心欲吐，脉而数疾无伦，竟有阴从下
脱，阳从上脱之意焉。急急大补，俾得抱一不离，已恐鞭长莫及。
人参 麦冬 五味子 坎 牡蛎 龙骨 河车 川柏 茯神 蕤仁 枣仁
转方加黄芩、灶心土，余根据上法。
仔细推究病源，本属于暑、湿、热三气致病。起初是湿邪导致的大便闭塞，后来转为热邪结聚，所感受的暑邪怎能不长久变化呢？然而这只是初、中、末三个阶段阐述其常理，尚未言及其变证。所谓的变证是什么？昔日身体肥胖如今消瘦，瘦人多火，湿气已经化火，火热已经趋向于燥，更何况还有其他的变证。痰结在肺经，取效于葶苈子、杏仁；热结在肠间，又出现大便像栗子一样干硬。甚至肺与大肠互为表里，二金（指肺与大肠，或指代相关脏腑功能）同受火邪刑伤，皮肤干燥脱屑，这难道不是湿生痰、痰生热、热生风的验证吗？至于水液混浊都属于热证，内热导致痿证，不能起床，鼻子的干燥、耳朵的鸣响、眼睛流泪，热象不一而足，阴分也多处受伤。至于口中不渴，似乎令人不解，但其实也不难理解。说是久病入络，络脉也主血，血主濡润，所以只是口干而不觉得口渴。遵循“无阴则阳无以化”的例子，请指正。
阴络受伤则血液外溢，血液在内溢出则出现便血。血从后阴排出已经数年，时发时止，只有去年发作得厉害。今年春天营血日益亏损，卫气更加虚弱。虚则气不能摄血，也因为咳嗽而来，阳络更受损伤，中焦失守，不仅肝肾内部虚弱，难怪前面浮肿，后面喘促。甚至不想饮食，恶心欲吐，脉搏数疾无比，竟然有阴气从下脱失，阳气从上脱失的意思。急忙大补，使得抱一不离（阴阳相守），已经恐怕鞭长莫及了。
Carefully analyzing the source of the disease, it originally belongs to the pathogenic factors of Summerheat (Shu), Dampness (Shi), and Heat (Re). Initially, there was constipation due to Dampness obstruction, followed by heat accumulation. How could the contracted Summerheat pathogen fail to undergo prolonged transformation? However, this merely describes the normal progression through the initial, middle, and terminal stages, without yet addressing the variations. What are these variations? The patient was formerly obese but is now emaciated; emaciated individuals tend to have internal fire. The Dampness has transformed into Fire, and the Fire has turned towards Dryness. Moreover, there are further variations: Phlegm (Tan) accumulates in the Lung Meridian, responding well to Tinglizi (Lepidii Semen) and Xingren (Prunus Armeniaca Seed); Heat (Re) binds in the intestines, resulting in stools as hard as chestnuts. Since the Lung and Large Intestine are exterior-interior partners, both are subjected to the punishment of Fire. The skin becomes dry and peels off. Is this not a verification of "Dampness generates Phlegm, Phlegm generates Heat, and Heat generates Wind"? As for turbid body fluids, they all belong to Heat. Internal Heat causes Wei Syndrome (flaccidity syndrome), rendering the patient unable to get out of bed. Dryness of the nose, tinnitus of the ears, and tearing of the eyes present various manifestations of Heat, injuring the Yin in multiple ways. Regarding the lack of thirst in the mouth, which seems puzzling, it is actually not difficult to understand. It is said that chronic diseases enter the Collaterals (Luo Mai); the Collaterals also govern Blood (Xue), and Blood provides moistening. Therefore, there is dryness without thirst. Following the principle that "without Yin, Yang cannot transform," I respectfully request your correction.
Fresh Polygonum multiflorum Rhizome (Xian Shouwu), Gardenia Fruit (Shanzhi) stir-fried with ginger, Aragon (Shijueming), Fangjie Qingyan, Apricot Kernel (Xingren), Achyranthes Root (Niuxi), Biota Seed (Baiziren).
When the Yin Collaterals are injured, blood overflows; when blood overflows internally, hematochezia occurs. Bleeding from the posterior orifice has persisted for several years, occurring intermittently, with severe exacerbation last year. In the spring of this year, Ying-Blood (Nutritive Blood) has been daily depleted, and Wei-Qi (Defensive Qi) has become increasingly deficient. Deficiency leads to Qi's inability to contain blood. This is also triggered by coughing, further injuring the Yang Collaterals. The Middle Jiao loses its control. Not only are the Liver and Kidney internally deficient, but it is no wonder that edema appeared previously and panting followed subsequently. There is even loss of appetite, nausea, and vomiting. The pulse is rapid and frantic beyond measure, suggesting that Yin is collapsing from below and Yang is collapsing from above. Urgent massive tonification is required to keep Yin and Yang united, though it may already be too late to save the situation.
Ginseng Root (Renshen), Ophiopogon Tuber (Maidong), Schisandra Berry (Wuweizi), Umbilical Cord (Kanqi), Oyster Shell (Muli), Dragon Bone (Longgu), Placenta Humanis (Heche), Phellodendron Bark (Chuanbai), Poria Sclerotium (Fushen), Prunus Persica Seed (Ruiren), Ziziphus Seed (Zaoren).
The modified prescription adds Scutellaria Root (Huangqin) and Caulis Ziziphi Spinosae Ash (Zaoxintu); the rest follows the previous method.